The Delphi Method as a Consensus-Building Tool in Designing an Application Framework for Artificial Intelligence in Medical Education in Spain.
Abstract
Introduction. The rapid integration of artificial intelligence (AI) into biomedical education has created an urgent need for a framework that can guide both learners and academic staff. In Spain, where institutions are adopting AI at speed but without homogeneous regulatory or pedagogical guidance, structured approaches are required to prioritize competencies and address ethical, legal and educational challenges. Methods. A Delphi study was coordinated by the Universidad Europea de Madrid, using the REDCap platform to manage iterative rounds. The project received financial support from the Spanish Society for Medical Education (SEDEM). Experts in medical education, including some with specific AI expertise, participated in a sequence of online questionnaires. Through anonymized feedback, participants evaluated, refined and prioritized a core of areas where the impact of AI seems essential. Results. Experts agreed on the need for skills extending beyond technical literacy, emphasizing critical thinking, interpretation of AI‑generated outputs, bias awareness and professional responsibility. Ethical and legal considerations, particularly concerning privacy, transparency and decision‑making, were strongly prioritized. Participants also highlighted the transversal nature of AI, suggesting that competencies should be embedded across curricula rather than treated as isolated content. Discussion. Despite institutional heterogeneity, consensus converged on areas that balance innovation with ethical safeguards. The results support the development of a competency‑based framework capable of guiding curriculum design, informing faculty development and promoting responsible, evidence‑informed use of AI while safeguarding professional autonomy.
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References
1. Masters K. Artificial intelligence in medical education. Medical Teacher. 2019, 41(9), 976–80. https://doi.org/10.1080/0142159X.2019.1595557
2. Salam A, Abdelhalim AT, Begum H, Pasha MA. Faculty Development in Medical Education: What, Why and How. Int J Hum Health Sci. 2023, 7(1), 3–8. https://doi.org/10.31344/ijhhs.v7i1.489
3. Zidoun Y, Mardi AE. Artificial Intelligence (AI)-Based simulators versus simulated patients in undergraduate programs: A protocol for a randomized controlled trial. BMC Med Educ. 2024, 24(1), 1260. https://doi.org/10.1186/s12909-024-06236-x
4. Schubert T, Oosterlinck T, Stevens RD, Maxwell PH, Schaar M van der. AI education for clinicians. eClinicalMedicine. 2025, 79. https://doi.org/10.1016/j.eclinm.2024.102968
5. Zhou J, Zhang J, Wan R, Cui X, Liu Q, Guo H, et al. Integrating AI into clinical education: evaluating general practice trainees’ proficiency in distinguishing AI-generated hallucinations and impacting factors. BMC Med Educ. 2025, 25(1), 406. https://doi.org/10.1186/s12909-025-06916-2
6. Weidener L, Fischer M. Artificial Intelligence Teaching as Part of Medical Education: Qualitative Analysis of Expert Interviews. JMIR Medical Education. 2023, 9(1), e46428. https://doi.org/10.2196/46428
7. Artificial intelligence in education - AI | UNESCO [Internet]. 2025 [cited 2026 Feb 10]. Available from: https://www.unesco.org/en/digital-education/artificial-intelligence
8. Cai C, Duell J, Minghui Chen D, Kin Ho W, Kwong Lee BT, Li F, et al. Advancing AI Literacy in Medical Education: A Medical AI Competency Framework Development. In: Cristea AI, Walker E, Lu Y, Santos OC, Isotani S, editors. Artificial Intelligence in Education. Cham: Springer Nature Switzerland; 2025, p. 116–23. https://doi.org/10.1007/978-3-031-98462-4_15
9. Atkinson-Toal A, Guo C. Generative Artificial Intelligence (AI) Education Policies of UK Universities. Enhancing Teaching and Learning in Higher Education. 2024, 2, 70–94. https://doi.org/10.62512/etlhe.20
10. Australian Framework for Artificial Intelligence in Higher Education - ACSES [Internet]. [cited 2026 Mar 11]. Available from: https://www.acses.edu.au/publication/australian-framework-for-artificial-intelligence-in-higher-education/
11. Humphrey-Murto S, Ho Lee S, Gottlieb M, Horsley T, Shea B, Fournier K, et al. Protocol for an extended scoping review on the use of virtual nominal group technique in research. PLoS One. 2023,18(1), e0280764. https://doi.org/10.1371/journal.pone.0280764
12. López-Gómez E. El método Delphi en la investigación actual en educación: una revisión teórica y metodológica. Educación XX1. 2018, 21(1). https://doi.org/10.5944/educxx1.20169
13. Hsu CC, Sandford BA. The Delphi Technique: Making Sense of Consensus. Practical Assessment, Research, and Evaluation. 2007, 12(1). https://doi.org/10.7275/pdz9-th90
14. Okoli C, Pawlowski SD. The Delphi method as a research tool: an example, design considerations and applications. Information & Management. 2004, 42(1), 15–29. https://doi.org/10.1016/j.im.2003.11.002
15. Castaño SC. La inteligencia artificial en Salud Pública: oportunidades, retos éticos y perspectivas futuras. Revista Española de Salud Pública. 2025, 99,12. https://ojs.sanidad.gob.es/index.php/resp/article/view/1006
16. Davis FD. A technology acceptance model for empirically testing new end-user information systems : theory and results [Thesis] [Internet]. Massachusetts Institute of Technology; 1985 [cited 2025 Aug 1]. Available from: https://dspace.mit.edu/handle/1721.1/15192
17. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989,13(3), 319–40. https://doi.org/10.2307/249008
18. Jiang S, Li H, Gan D. Technology acceptance model for online education: identifying interdisciplinary topics and their evolution based on BERTopic model. Social Sciences & Humanities Open. 2025,12,101831. https://doi.org/10.1016/j.ssaho.2025.101831
19. García de Blanes Sebastián M. Aplicación de la teoría unificada de aceptación y uso de la tecnología extendida (utaut 2) para estimar la intención de uso de la tecnología. Desarrollo de un modelo predictivo para la plataforma de pago móvil peer-to-peer y los asistentes virtuales [Internet]. 2023 Feb 17 [cited 2026 Mar 10]. Available from: https://hdl.handle.net/10115/28651
20. Mulyani H, Istiaq MA, Shauki ER, Kurniati F, Arlinda H. Transforming education: exploring the influence of generative AI on teaching performance. Cogent Education. 2025, 12(1), 2448066. https://doi.org/10.1080/2331186X.2024.2448066
21. Abujaber AA, Abd-Alrazaq A, Al-Qudimat AR, Nashwan AJ. A Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis of ChatGPT Integration in Nursing Education: A Narrative Review. Cureus. 2023, 15(11), e48643. https://doi.org/10.7759/cureus.48643
22. Schifano J, Niederberger M. How Delphi studies in the health sciences find consensus: a scoping review. Syst Rev. 2025, 14(1),14. https://doi.org/10.1186/s13643-024-02738-3
23. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. Journal of Biomedical Informatics. 2019, 95,103208. https://doi.org/10.1016/j.jbi.2019.103208
24. Lavigne E, Lopez A, Frandon J, Blaizot G, Gabellier L, Adham S, et al. AI-Standardized Clinical Examination Training on OSCE Performance. NEJM AI. 2025, 2(8), AIoa2500066. https://doi.org/10.1056/AIoa2500066
25. Organization WH. Ethics and governance of artificial intelligence for health: large multi-modal models. WHO guidance. World Health Organization; 2024, 98 p.https://www.who.int/publications/i/item/9789240084759
26. Smuha NA. Regulation 2024/1689 of the Eur. Parl. & Council of June 13, 2024 (EU Artificial Intelligence Act). International Legal Materials. 2025, 64(5), 1234–381. https://doi.org/10.1017/ilm.2024.46
27. Hariyanto, Kristianingsih FXD, Maharani R. Artificial intelligence in adaptive education: a systematic review of techniques for personalized learning. Discov Educ. 2025, 4(1), 458. https://doi.org/10.1007/s44217-025-00908-6
28. Bittle K, El-Gayar O. Generative AI and Academic Integrity in Higher Education: A Systematic Review and Research Agenda. Information. 2025, 16(4). https://doi.org/10.3390/info16040296
29. Gonsalves C. Generative AI’s Impact on Critical Thinking: Revisiting Bloom’s Taxonomy. Journal of Marketing Education. 2024, 02734753241305980. https://doi.org/10.1177/02734753241305980
30. Sardi J, Darmansyah, Candra O, Yuliana DF, Habibullah, Yanto DTP, et al. How Generative AI Influences Students’ Self-Regulated Learning and Critical Thinking Skills? A Systematic Review. International Journal of Engineering Pedagogy (iJEP). 2025, 15(1), 94–108. https://doi.org/10.3991/ijep.v15i1.53379
31. Mawyin-Muñoz CE, Salmerón-Escobar FJ, Hidalgo-Acosta JA, Calderon-León MF. Medical simulation: an essential tool for training, diagnosis, and treatment in the 21st century. BMC Med Educ. 2025, 25(1),1019. https://doi.org/10.1186/s12909-025-07610-z
32. Kloos CD, Alario-Hoyos C, Estévez-Ayres I, Callejo-Pinardo P, Hombrados-Herrera MA, Muñoz-Merino PJ, et al. How can Generative AI Support Education? In: 2024 IEEE Global Engineering Education Conference (EDUCON) [Internet]. 2024 [cited 2026 Feb 11]. p. 1–7. https://ieeexplore.ieee.org/abstract/document/10578716, https://doi.org/10.1109/EDUCON60312.2024.10578716
33. Razzak NA. The Double-Edged Sword of Generative AI: Enhancing or Hindering Students’ Intellectual Growth? In: 2025 IEEE International Conference on Emerging Trends in Engineering and Computing (ETECOM) [Internet]. 2025 [cited 2026 Feb 11]. p. 1–7. https://ieeexplore.ieee.org/abstract/document/11319048, https://doi.org/10.1109/ETECOM66111.2025.11319048
34. Fernández Cerero D. Inteligencia artificial para la formación docente sanitaria. 2024, 1–126. https://www.dykinson.com/libros/inteligencia-artificial-para-la-formacion-docente-sanitaria/9788410702370/
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